Doctor Employment Lawyer Blog

If you are in the last year of your residency, you have every reason to celebrate. After years of studying, learning and making a modest income, it is finally time to improve your career significantly in terms of pay, benefits and specialization. You have worked hard to get here, and it is important to not lose sight of your career path and your goals. Stay the course and avoid common mistakes made by residents during and after their final year.

Even if you unsure as to whether you want to pursue a fellowship, apply early and ask questions. If you wait until the last year of your residency to apply for a fellowship, it may be too late. Try to apply as early as two years before your residency will come to a close and no later than 1.5 years before it ends. When you do apply in a timely fashion and are accepted for your fellowship, you may receive little information as to your expectations. Most residents are only fully informed about their pay. However, this is not enough information for you to know how many research projects you should complete or when and how much you will be on call. Have a list of questions prepared and use a bit of finesse to get them answered early on. If you have done your homework and have established expectations with the leaders of your program and then there is a change in leadership, be sure to have the conversation all over again to discover any new rules or expectations and reassess your options.

After your fellowship, don't jump into the first job offer right off the bat. Although it is tempting to get started immediately because you are excited to be finished with your residency and the money looks good, think carefully instead and ask probative questions. Make sure this is what you want. Also, take time to talk to your recruiter, if you have one. It won't cost you anything, and they may be able to help you compare options. If you already have contracts in hand to consider, you may want to take the next step and engage an attorney to help you negotiate and/or understand what you are about to sign. Apart from legal and professional considerations, think long and hard about how you want to shape your personal life. What is important to you? Likely, you will be signing a contract with a length of a year or more. One, two or three years is a long time to be stuck in an environment you don't like while missing out on precious time with your family and friends. Pay extra attention to what the local community is saying about your potential employer and closely scrutinize the schedule expectations and additional commitments that may be hidden in your contract. If you are going to be a partner, spend time with your future partners. Make sure you can trust them and that they are forthright and honest with you. Have people you trust meet them. Have frank conversations and make sure your goals, integrity and ethics are aligned.

Finally, after you have a stake in a practice that you've formed or entered into after much evaluation, you should be ready to run it and run it well. It is up to you to develop long-term strategies that will benefit you, your partners, your employees and the patients. It is important to run an efficient practice from a business standpoint while still allowing those who work there to maintain a certain quality of life. New physicians will be evaluating you as you interview them. Be ready to go beyond a simple salary explanation. Residents will likely evaluate practice opportunities with questions regarding incorporation, ownership shares, buy-in, benefits, malpractice insurance, daily census, technology, billing, marketing and profitability. Have these issues worked out ahead of time so that you make the cut and attract the best physician employees.

There are a number of great medical centers in Illinois, and the Chicago area in particular. And, ostensibly there is a lot of opportunity in Illinois for physicians. But, many doctors do not want to go into hospital employed practice. Some physicians look to get into private practice, where they can potentially move into an ownership role and have an impact on the business side of medicine.

While many hospitals will pay for continuing or tail coverage after a physician leaves employment, most private practices specifically place the responsibility for such coverage on the individual physician. For some practice areas, the expense for tail coverage can be staggering in Illinois. At the same time, just over the border in Indiana (not to mention other further states), malpractice coverage costs are significantly lower.

Physicians in Illinois who read their private practice employment agreements carefully may be able to negotiate tail coverage provisions, but many doctors focus primarily on the terms addressing compensation and non-competition. Some physicians are completely unaware of the potential long term costs of their employment arrangement.

The effect of high tail coverage costs has led many physicians with ties to Illinois to seek out of state employment. We are especially seeing this in high cost specialties such as obstetrics. And, it does not appear that effective insurance reform can be expected anytime soon. Because of this, it is crucial that doctors review and negotiate terms of tail coverage before accepting employment.

A physician who properly negotiates his/her contract before accepting employment, can often minimize the financial exposure of a move down the line. It's disheartening to know that you will have to pay large amounts of money to ever change employers, but it's just plain naive not to address the issue before starting employment.